Tetanus

Yen, Lam Minh; Thwaites, C. Louise

doi:10.1016/s0140-6736(18)33131-3

Cited by 178 publications

(310 citation statements)

References 103 publications

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“…What is more, neither the history of reimmunization nor the history of immune strengthening was known for most patients in our study, and a research showed that screening for tetanus antibodies in their participants indicated an antibody positivity rate of only 47.62% [8]. Therefore, it is necessary to improve tetanus immunity among adults or posttraumatic patients as well as groups with an unknown early immunization history to further reduce the incidence of tetanus [2,9].…”

Section: Discussionmentioning

confidence: 84%

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Multicenter Study of Tetanus Patients in Fujian Province of China: A Retrospective Review of 95 Cases

Wang

Shang

et al. 2020

BioMed Research International

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Background. Tetanus is a life-threatening disease in developing countries and is accompanied by a high mortality rate. Although China is the world’s largest developing country, there have been few clinical studies on tetanus in China. The purpose of this study was to investigate the epidemiology, incidence, and management of tetanus in Fujian Province and to understand the current treatment and prognosis of tetanus patients. Methods. This was a retrospective, multicenter observational study of patients who presented with a clinical diagnosis of tetanus at 5 general hospitals in Fujian from January 2008 to December 2018. Data were analyzed using a computer software system. Results. A total of 95 patients were recruited, including 6 newborns. The average age of the adult tetanus patients was 55.53±15.39 years old. None of the patients knew their previous history of tetanus immunization. The rate of having received human tetanus immunoglobulin (HTIG) was 9.47%. A total of 73 (76.84%) patients were cured, 17 (17.89%) patients had an unknown prognosis, and 5 (5.26%) patients died. Age, severity of illness, and complications all increased the total duration of hospitalization. Compared with endotracheal intubation, tracheotomy increased the length of stay in the ICU (Intensive Care Unit) but did not affect the total hospital length of stay for mechanical ventilation. Conclusions. With the promotion of nationwide immunization against tetanus and the development of critical care medicine, morbidity and mortality rates of tetanus in Fujian are low. It is important to increase awareness among local physicians and staff in charge of tetanus immunization programs and with regard to neonatal tetanus and drug-induced tetanus. The prevention and treatment of tetanus in developing countries should arouse widespread concern in society.

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Section: Discussionmentioning

confidence: 84%

“…Tetanus is still a common disease in developing countries and has a high mortality rate [1]. Although the incidence of tetanus in developed countries is low and the prognosis good, the medical burden of tetanus remains high [2].…”

Section: Introductionmentioning

confidence: 99%

Multicenter Study of Tetanus Patients in Fujian Province of China: A Retrospective Review of 95 Cases

Wang

Shang

et al. 2020

BioMed Research International

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“…For instance, Clostridium botulinum produces the lethal botulinum toxin, which causes botulism [40]. Other species from the genus Clostridium include Clostridium tetani, the causative agent of tetanus, Clostridium perfringens, which causes gas gangrene, Clostridium difficile, the cause of diarrhea [41][42][43]. Unfortunately we could not analyze bacteria on a species-level as the V3 and V4 regions which are detected with 16S rRNA sequencing are highly preserved.…”

Section: Discussionmentioning

confidence: 99%

The urinary microbiome shows different bacterial genera in renal transplant recipients and non-transplant patients at time of acute kidney injury – a pilot study

et al. 2020

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Background: In the past urine was considered sterile. Through the introduction of next generation sequencing, it has become clear that a urinary microbiome exists. Acute kidney injury (AKI) represents a major threat to kidney transplant recipients. Remarkable changes in the urinary metabolome occur during AKI, which may influence the urinary microbiome. To our knowledge, this is the first study that examines the urinary microbiome in renal transplant recipients (RTX) and non-transplant recipients (nRTX) at time of AKI.Methods: In this cross-sectional pilot-study the urinary microbiome of 21 RTX and 9 nRTX with AKI was examined. Clean catch morning urine samples were obtained from all patients on the first day of AKI diagnosis. AKI was defined according to KDIGO guidelines. Urinary microbiota and the urinary metabolome during AKI were assessed in one patient. 16S rRNA sequencing was performed. Sequences were processed using UPARSE-pipeline for operational taxonomic units (OTU) and taxon finding. Results: We successfully extracted and sequenced bacterial DNA from 100% of the urine samples. All 30 patients revealed at least 106,138 reads. 319 OTU and 211 different genera were identified. The microbiotic diversity richness in the RTX group was no different from the nRTX group. Eighteen genera were solely present in nRTX and 7 in RTX. Conclusions: The urinary microbiome at time of AKI showed different bacterial genera in RTX compared to nRTX. The nRTX group exhibited no different diversity to the RTX group. Irrespective of the status of a previous renal transplantation, the urinary microbiome comprised > 210 different genera. An intraindividual change in microbiota diversity and richness was observed in one study patient during recovery from AKI.

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“…Robust methods of detecting ANSD suitable for implementation in resource-limited settings where most tetanus occurs would allow earlier intervention and may improve outcome. Diagnosis is currently based on non-specific clinical signs of pyrexia, sweating and increased or fluctuating heart rate and blood pressure 3 . Other methods include 24-hour collections of urinary catecholamines, but this has low specificity, unsuitable for routine use 4 .…”

Section: Introductionmentioning

confidence: 99%

Heart rate variability as an indicator of autonomic nervous system disturbance in tetanus

Duong¹,

Tadesse

Nhat

et al. 2019

Preprint

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Autonomic nervous system dysfunction (ANSD) is a significant cause of mortality in tetanus.Currently diagnosis relies on non-specific clinical signs. Heart rate variability (HRV) may indicate underlying autonomic nervous system activity and represents a potentially valuable non-invasive tool for ANSD diagnosis in tetanus. HRV was measured from 3 5-minute ECG recordings during a 24hour period in a cohort patients with severe tetanus, all receiving mechanical ventilation. HRV measurements from all subjects -5 with ANSD (Ablett Grade 4) and 4 patients without ANSD (Ablett Grade 3) -showed HRV was lower than reported ranges for healthy individuals. Comparing different severities of tetanus, raw data for both time and frequency measurements of HRV were reduced in those with ANSD compared to those without. Differences were statistically significant in all except root mean square standard deviation RMSSD (p=0.07) indicating HRV may be a valuable tool in ANSD diagnosis.

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Tetanus

Cited by 178 publications

References 103 publications

Multicenter Study of Tetanus Patients in Fujian Province of China: A Retrospective Review of 95 Cases

Multicenter Study of Tetanus Patients in Fujian Province of China: A Retrospective Review of 95 Cases

The urinary microbiome shows different bacterial genera in renal transplant recipients and non-transplant patients at time of acute kidney injury – a pilot study

Heart rate variability as an indicator of autonomic nervous system disturbance in tetanus

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